Abstract
Breast cysts are associated with an increased risk of breast cancer. Some biomarkers such as estrogen receptor alpha (ERa), progesterone receptor (PR), and cyclin D1, show similar patterns of expression in epithelial cells lining breast cysts as malignant epithelial cells in local and invasive ductal breast cancer. We have attempted to answer two questions: (1) Do epithelial cells lining breast microcysts (cysts which can only be seen with a microscope) express biomarkers in a similar pattern to breast ductal carcinoma in situ and invasive ductal carcinoma? (2) Are breast microcysts precursors of breast cancer or are they part of normal involution of the breast?
Seventy two archival open breast biopsy specimens of ductal carcinoma in situ and invasive ductal carcinoma and 32 normal breast biopsies from Australian women who had breast reduction surgery were selected from hospital archives. All specimens were analysed by standard immunohistochemistry for ERa, PR, cyclin D1, bcl-2, p53 and erbB-2 expression.
In the same specimens, the pattern of high biomarker expression was very similar for all the above biomarkers in epithelial cells lining microcysts and in both ductal carcinoma in situ and invasive ductal carcinoma c. ErbB-2 was not expressed in normal control specimens. ErbB-2 was expressed in the same specimens in an increasing proportion of normal breast acini, microcysts and cancer cells in 36% of specimens with breast cancer.
An apparent progression was observed from normal breast acini, to proliferation of epithelial cells in microcysts, ductal carcinoma in situ and invasive ductal carcinoma in the same specimen.
When these findings are considered with other reports we conclude: (1) that epithelial cells lining breast cysts highly express biomarkers in a similar pattern to ductal carcinoma in situ and invasive ductal carcinoma; (2) that some microcysts are not part of normal involution of the breast and in some women may be part of the transition from normal to cancer.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Hayward JL, Parks AG: Alterations in the microanatomy of the breast as a result of changes in the hormonal environ-ment. In: Currie AR (ed) Endocrine Aspects of Breast Cancer. Livingstone, London, 1958
Shoker BS, Jarvis C, Sibson DR, Walker C, Sloane JP: Oes-trogen receptor expression in the normal and pre-cancerous breast. J Pathol 188: 237–244, 1999
Oyama T, Maluf H, Koerner F: Atypical cystic lobules: an early stage in the formation of low grade ductal carcinoma in situ. Virchows Arch 435: 413–421, 1999
Tsuchiya S: Atypical ductal hyperplasia, atypical lobular hy-perplasia and interpretation of a new borderline lesion. Jpn J Cancer Clin 44: 548–555, 1998
Kusama R, Fujimori M, Matsuyama I, Fu L, Ishi K, Hama Y, Asanuma K, Shingu K, Kobayashi S, Tsuchiya S-I: Clini-copathological characteristics of atypical cystic duct (ACD) of the breast: assessment of ACD as a precancerous lesion. Pathol Inter 50: 793–800, 2000
Bruzzi P, Dogliotti L, Naldoni C, Bucchi L, Costantini M, Cicognani A, Torta M, Bruzzi GF, Angeli A: Cohort study of association of risk of breast cancer with cyst type in women with gross cystic disease of the breast. BMJ 314: 925–928, 1997
Dixon JM, McDonald C, Elton RA, Miller WR: Risk of breast cancer in women with palpable breast cysts: a prospective study. Lancet 353: 1742–1745, 1999
Lawson JS, Field AS, Champion S, Tran D, Ishikura H, Trichopoulos D: Low oestrogen receptor alpha expression in normal breast tissue underlies low breast cancer incidence in Japan. Lancet 354: 1787–1788, 1999
Mommers ECM, Van Diest PJ, Leonharrt AM, Meijer CJLM, Baak JPA: Expression of proliferation and apoptosis related proteins in usual ductal hyperplasia of the breast. Hum Pathol 29: 1539–1545, 1998
Bur ME, Zimarowski MJ, Schnitt SJ, Baker S, Lew R: Estro-gen receptor immunohistochemistry in carcinoma in situ of the breast. Cancer 69: 1174–1181, 1992
Gillett CE, Lee AHS, Millis RR, Barnes DM: Cyclin D1 and associated proteins in mammary ductal carcinoma in situ and atypical ductal hyperplasia. J Pathol 184: 396–400, 1998
Ricketts D, Turnbull L, Ryall G, Bakhshi R, Rawson NSB, Gazet J-C, Coombes RC: Estrogen and progesterone receptors in the normal female breast. Cancer Res 51: 1817–1822, 1991
Soderqvist G, Von Schoultz B, Tani E, Skoog L: Estrogen and progesterone receptor content in breast epithelial cells from healthy women during the menstrual cycle. Am J Obstet Gynecol 168: 874–879, 1993
Strickland LB, Dawson PJ: The hyperplasia to carcinoma se-quence in the breast. Appl Immunohistochem Mol Morphol 8: 98–103, 2000
Aubele M, Cummings M, Walch A, Zitzelberger H, Nahrig J, Hofler H, Werner M: Heterogenous chromosomal aberrations in intraduct breast lesions adjacent to invasive carcinoma. Anal Cell Path 20: 17–24, 2000
Schuerch C, Rosen PP, Hirota T, Itabashi M, Yamamoto H, Kinne DW, Beattie Jr EJ: A pathologic study of benign breast diseases in Tokyo and New York. Cancer 50: 1899–1903, 1982
Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J: Can-cer Incidence in Five Continents. Vol VII, IARC Scientific Publications 143, Lyon, 1997
Shimizu H, Ross RK, Bernstein L, Pike MC, Henderson BE: Serum oestrogen levels in postmenopausal women: compar-ison of American whites and Japanese in Japan. Br J Cancer 62: 451–453, 1990
Adami HO, Signorello LB, Trichopoulos D: Towards an un-derstanding of breast cancer etiology. Semin Cancer Biol 8: 255–262, 1998
Henderson BE, Feigelson HS: Hormonal carcinogenesis. Carcinogenesis 21: 427–433, 2000
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tran, D.D., Lawson, J.S. Microcysts and Breast Cancer: A Study of Biological Markers in Archival Biopsy Material. Breast Cancer Res Treat 75, 213–220 (2002). https://doi.org/10.1023/A:1019969730552
Issue Date:
DOI: https://doi.org/10.1023/A:1019969730552